Management of AN in children requires serial clinical and audiometric evaluations, with a prominent role for behavioral testing. Prematurity, genetics, and hyperbilirubinemia appear to be significant factors in the development of AN; hyperbilirubinemia can be associated with spontaneous improvement of hearing thresholds. For those children not benefiting from amplification or FM systems, cochlear implantation remains a potentially successful method of habilitation.
The findings indicate that it is unlikely that the co-morbidity between ADHD and ODD/CD is due to environmental influences that are independent of ADHD. Rather it is likely to be due to a shared genetic liability either operating directly, or indirectly through gene-environment correlations or interactions. The covariation between phenotypes across informants and time is governed by a common set of genes, but it seems that ODD/CD is also influenced by additional genetic factors. Developmentally, different forms of genetic liability control ADHD in males and inattention in females.
The early adult functioning of 89 women from inner London who had been reared in residential Children's Homes was compared with that of 41 women sampled from the general population of the same area. The behaviour of both groups had previously been studied in middle childhood by means of standardized questionnaires. The adult assessment comprised detailed standardized interviews with the women and with their spouses, together with systematic observations of motherxhild interaction in the home for those with 2-34-year-old children. The adult outcome of the institution-reared women as a whole was substantially worse than that for the comparison group, but the course of their personality development had been greatly modified by positive school experiences in childhood and by the characteristics of their spouse and marriage in adult life. The institution-reared women in good psychosocial circumstances in adulthood functioned as well as the comparison group women. The findings are interpreted in terms of direct and indirect effects of experiences leading to both continuities and discontinuities in social development.
IntroductionA good deal is known about the various genetic and experiential factors that put children at risk for deviant personality development and for disorders of psychosocial functioning (see Rutter & Madge, 1976; Rutter, 1981; Rutter & Giller, 1983). However, with risk factors of all kinds and of all severities it has been a near-universal finding that many children do not succumb. Indeed, it is quite difficult to find any combination of risk factors that gives rise to significant disorder or dysfunction in more than half of the children exposed. For many years there was little interest in this well-demonstrated phenomenon. Often, there was the implicit assumption that the disorder was simply covert, present under the surface waiting to be revealed. Alternatively, it was supposed that the children at risk who failed to develop disorder had somehow received a lesser 'dose' of the risk factor or that temperamentally they were 'tougher' characters.
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